Get new jobs by email
- ...Position Summary: The Utilization Review Pharmacist is responsible for conducting clinical reviews of medication requests to determine medical necessity, appropriateness, and compliance with plan guidelines. Working closely with medical directors, case managers, and...
- Roles and Responsibilities - Manages a staff of professional-level team members or manages a team through lower-level supervisors manging healthcare Payer claims adjudication process - Works within general policies and management guidance, independently determining...
- ...JOB SUMMARY We are seeking a skilled Utilization Review Coordinator (URC) to oversee patient insurance certification, compliance with governmental regulations related to hospital stays, and the prevention of denials. Embedded within our utilization review management...
- ...Utilization Review Nurse Location: Philippines About Us: HBiz is a leading Revenue Cycle Management (RCM) company dedicated to helping healthcare providers optimize their financial performance. We specialize in delivering innovative solutions that streamline revenue...
- Utility Worker Duties and Responsibilities Perform routine maintenance for our gas, power, or water systems Perform manufacturing sanitation duties at our facility, including sweeping floors and keeping appliances in good working condition Operate various equipment and...
Infinity Outsourcing Services
Angono, Rizalmore than 2 months ago - ...in a healthcare BPO clinical setting Alternatively, 4 to 7 years of specialized experience in Clinical Authorization or Utilization Review Strong knowledge of EPIC , MCG , or InterQual guidelines Must have a stable work history with minimal employment...
- ...highly skilled and detail-oriented Peer Review Specialist to support our Residential, PHP... ...documentation practices that support utilization review. Proactively track authorization... ...pressure. Requirements This is a full time job 100% Remote $10-$11/hr...
- ...dealing with US Healthcare Insurance accounts, particularly in Utilization Management. This position entails semi-back-office work... ...Appeals, Prior Authorization, and particularly in MDS Utilization Review . Account Specific Roles and Responsibilities: ~ Performs...
- ...hustle Our client is looking for a Tax Reviewer to join their fast-growing, pharmacy-focused... ...U.S. firm that recognizes the value of remote professionals who bring expertise and... ...correspondence. Technology & Innovation Utilize modern tax software tools (e.g., Lacerte,...
- ...solutions, from AI-driven claims processing, Utilization management to program integrity,payment... ...: Chennai, Tamil Nadu, India (or Remote only for Phillipines based candidates )... ...this role, you will be responsible for reviewing and analyzing clinical information to determine...
- ...the accounting industry. About the role …. As a Tax Reviewer at our firm, you will play a critical role in overseeing and... ...papers and client correspondence. Technology & Innovation Utilize modern tax software tools (e.g., Lacerte, QuickBooks) to review...
- ...and responsibilities assigned from time to time Qualifications: Must be a high school graduate Must possess at least six (6) months experience as a messenger/utility man in a related industry Ability to manage multiple tasks within given time frames...
- ...Professional & Technical Skills: - Required Skill: Expert proficiency in Oracle Utilities Customer Care & Billing SPL - Strong understanding of software development principles and methodologies - Experience in designing and developing applications using Oracle Utilities...
- Scope of Responsibilities: # Processes payment of per diem of the members of the Board of Directors (BOD)of the Bank # Processes payment of official expenses incurred by executive offices # Handles booking of flight for official travel of Bank personnel # Initials...
- ...Your Role The Compliance Review Specialist will conduct monitoring/quality assurance/review, and advisory of regulatory and AML/CFT compliance practices throughout Maybank Philippines Incorporated (MPI). He/she performs assessment and verification, on risk-based...
- ...What will you do In this position, you will join our Water Utilities team, where you will play an integral part in a team of highly... ...modelling outputs through verification, coordination, and peer review processes. Utilize digital tools like Plant 3D, Civil 3D, 12D...
- ...We're looking for a Privacy Incident Reviewer to join our Integrated Compliance Services team at MBPS. In this role, you are responsible in supporting the Privacy Office in monitoring and reviewing of privacy incidents reported through the official business application...
- ...materials comply with the standards set by the Advertising Standards Council (ASC) in the Philippines, we are seeking an ASC Material Review Specialist. Job Summary This role is responsible for managing the submission of all marketing materials for ASC approval,...
- ...The Credit Review Officer shall ensure that the Lending Units are in compliance with the applicable rules and regulations governing the credit process as well as the terms and conditions of individual loan approvals; Assesses if there are irregular practices, red flags...
- ...offices and laboratories, working together to enable a better, safer and more interconnected world. Job Description Document review and compliance Assures that reviewed QC records are compliant to methods, specifications and company's applicable Standard Operating...
- ...efficiency and drive growth for our clients. About the Role: Job Title: Registered Nurse – Quality Assurance (QA) Reviewer Location: Remote (Must work Central Time hours) Hours: Full-time, 37.5 hours/week Start Date: ASAP We are seeking a detail-...
- ...Are you looking for additional home health OASIS review work It's flexible, work-from-home, and pay is $7+ per hour plus bonuses. We&aposre Andy, a fast-growing US-based AI startup for home health nurses. We have a team of 100 across PH and would love for you to...
- ...The Documentation Review Unit Head shall be responsible for the day-to-day activities of the Documentation Analyst/s. He/She shall be responsible for managing volume and timeliness and ensuring of output of the staff under his/her team. Professional Experience...
- ...inclusiveness. Our differences are what fuel our creativity. What will you do In this position, you will join our Water Utilities team, where you will play an integral part in a team of highly skilled specialists that 'bring ideas to life' for our clients across...
- ...Management & Performance Supervise onboarding document analysts and support staff Conduct coaching sessions and regular performance reviews Ensure quality, accuracy, and timeliness in the work of the team Reporting & Governance Submit weekly and monthly...
- ...We are seeking a highly experienced and results-driven Project Manager to lead the execution of our utility-scale, grid-connected solar PV projects. The successful candidate will be responsible for the overall management of the project lifecycle, from project planning...
- ...oriented mindset. In this role, you'll be pivotal in providing remote IT support, ensuring our clients receive top-notch technical... ...completed with only one time entry contributes to this number -Utilization: The percentage of time that you are on the clock and billing...
Intelligent Technical Solutions (ITS)
Makatimore than 2 months ago - ...JOB RESPONSIBILITIES •Administers and overseas the conduct of credit review of all credit exposures by close monitoring of credit review schedules. •Leads and directs the exit discussion on results of counterparty credit or portfolio review by setting the...
- ...Job Summary ~ The Independent Credit Review Officer shall perform an unbiased assessment of the quality of the Bank&aposs aggregate credit portfolio through an evaluation of individual credits and the Bank&aposs credit procedures. This is in line with the requirements...
- ...procedures through a comprehensive and robust audit program. Review and where necessary adjust the loan submission to ensure the application... ...yourself. Work-Life Integration and Perks: WFH Engagements: Remote learning and employee development activities, Wellness sessions...
